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Instrumental delivery

Birthing, also called labour is the act or process of giving birth to offspring. Every woman’s labour is different, even from first pregnancy to the next. When a difficulty in labour is suspected and a baby needs help to be born, then instrumental delivery can be used to deliver the baby. Instrumental delivery, also called operative vaginal delivery or an assisted vaginal delivery is a way of helping the women to deliver her baby vaginally. An instrument assisted vaginal birth is of help during the end stage of labour in which the cervix is dilated completely but for some reasons the baby is unable to be born spontaneously. Special instruments such as vacuum extractor and forceps are used to assist delivery with least possible risk to the baby and the mother.
Your doctor may recommend an instrumental delivery if:

  • Your baby is not in a favourable position to be born easily
  • Your baby is deprived of enough oxygen which would cause distress
  • You are too tired and unable to push during contractions

Your doctor will ensure that the baby can be delivered vaginally in a safe manner before starting the procedure. A local anaesthetic injection is given inside the vagina (pudendal block) or an epidural or spinal block may be given for pain relief. Assisted delivery may be carried out with either vacuum extractor (ventouse delivery) or using forceps (forceps delivery).

In ventouse delivery, a soft plastic cup (ventouse) is placed on the top of the baby’s head. The cup is connected to a suction machine through tubing. The machine will be switched on and the plastic cup will be applied to the baby’s head by vacuum. During a contraction, your doctor will gently pull the plastic cup outwards and the cup has controlled amount of suction that helps deliver the baby. There is less pain and less damage to the mother by using a ventouse. The suction cup used may leave behind a mark on the baby’s head or bruise the baby’s head (cephalohaematoma). These will resolve over time.

Forceps delivery uses smooth metal instruments (forceps) specially designed to fit around the baby’s head. Forceps can protect the baby’s head but can be uncomfortable to the mother. An episiotomy (a cut to enlarge the opening) may be needed so that the forceps can be put round your baby's head. The forceps are cautiously placed around the baby’s head and held together at their handles. Once the forceps are in place, your doctor will try to gently pull the forceps outwards during a contraction to help deliver the baby. Forceps delivery may also leave tiny marks on the baby’s face which will fade off within few weeks.

Both these methods are usually safe and effective; your doctor will select the one most appropriate for your situation.